Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
2-Oxoglutaric acid, 2-oxopentanedoicic acid, 3-methylhistidine, AAKG, acétoglutarate (French), acide 2-oxoglutarique (French), acide a-cétoglutarique (French), acide alpha-cétoglutarique (French), a-ketoglutaric acid, AKG, alanine, alfa-cetoglutarato (Spanish), alpha keto glutarate, alpha ketoglutarate, alpha KG, alpha-cétoglutarate (French), alpha-cétoglutarate d'arginine (French), alpha-cétoglutarate de calcium (French), alpha-cétoglutarate de créatine (French), alpha-cétoglutarate de glutamine (French), alpha-cétoglutarate de L-arginine (French), alpha-cétoglutarate de L-leucine (French), alpha-cétoglutarate de taurine (French), alpha-ketoacid, alpha-ketoanalogs, alpha-ketoglutarate, alpha-ketoglutarate dehydrogenase (KGDHC), alpha-ketoglutarate-pyridoxine complex, alpha-ketoglutaric acid, alpha-ketoisocaproate, alpha-ketoisovalerate, alpha-ketomethylvalerate, ammonia, arginine, arginine alpha-ketoglutarate, arginine aspartate, calcium alpha-ketoglutarate (Ca-ket), creatine alpha-ketoglutarate (creatine AKG), diarginine alpha-ketoglutarate, glutamate, glutamine, glutamine alpha-ketoglutarate, glycine, histidine, hydroxyproline, L-arginine, L-leucine alpha-ketoglutarate, L-lysine alpha-ketoglutarate reductase, L-ornithine alpha-ketoglutarate, lysine, malate-oxalacetate, ornithine, ornithine alpha-ketoglutarate (OKG), ornithine transcarbamylase, oxoglutarate, phenylalanine, proline, pyridoxine AKG (PAK), pyruvate, pyruvic acid, taurine alpha-ketoglutarate, tyrosine, urea.
Alpha-ketoglutarate (AKG, also called oxoglutarate) plays an important role in several biological functions.
AKG has been used for kidney failure, dialysis, and malnutrition.
Ornithine alpha-ketoglutarate (OAKG or OKG) is made from two amino acids, ornithine and glutamine. It is marketed as a supplement for building muscle. OKG is not specifically discussed in this monograph; it is the topic of a separate monograph.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Preliminary research indicates that alpha-ketoglutarate (AKG) may improve recovery and prevent infection after surgery. Further studies are needed before a firm conclusion may be made.
Dialysis (waste removal from the blood)
Some research supports AKG for improving protein metabolism to treat high phosphate levels and malnutrition in patients receiving blood filtration. However, further research is required.
There is insufficient evidence to support the use of AKG for liver disease. More high-quality studies are required before a conclusion may be made.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Ammonia toxicity, antidote to poisons, antioxidant, athletic performance, bacterial infections, burns, candidiasis (fungal infection), cataracts, chemopreventive (disease-preventing), childhood growth promotion, chronic fatigue syndrome, critical illness, diabetes, energy, functional gastrointestinal disorders, high cholesterol, HIV support, immune function, intestinal problems, kidney disease, malnutrition, muscle atrophy (loss of muscle mass), neurological trauma, osteoporosis, peptic ulcers, stroke recovery, wrinkle prevention (topical).
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
For dialysis, 1.187 grams of AKG with 0.813 grams of calcium carbonate has been given three times weekly for one year. Also, 4.5 grams of calcium AKG has been given for 36 months.
For heart protection, 28 grams of AKG has been used during a heart operation. Also, 66 milliliters of AKG solution, at a concentration of 300 grams per liter, was injected into the vein after a heart operation.
Children (under 18 years old)
There is no proven safe or effective dose for alpha-ketoglutarate in children.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
There is no known allergy or sensitivity to alpha-ketoglutarate (AKG).
Side Effects and Warnings
Alpha-ketoglutarate is generally safe at a dose of 1.187 grams of AKG with 0.813 grams of calcium carbonate given three times weekly for one year. Sixty-six milliliters of AKG solution, at a concentration of 300 grams per liter, injected into the vein, is generally safe.
Alpha-ketoglutarate is possibly safe, at a dose of 4.5 grams daily of calcium AKG for 36 months, and 0.28 grams of alpha-ketoglutarate per kilogram of body weight after hip replacement surgery is also possibly safe.
Although alpha-ketoglutarate seems to be well tolerated, a physician should supervise its usage.
Use cautiously with Lipofundin® (a fat supplement for patients receiving nutrition intravenously) and amino acid supplements.
Use cautiously in pregnant or breastfeeding women or in children, due to a lack of sufficient safety data.
Pregnancy and Breastfeeding
Use of alpha-ketoglutarate is not suggested, as there is a lack of scientific evidence on the use of alpha-ketoglutarate during pregnancy or breastfeeding.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Alpha-ketoglutarate may interact with cardiovascular agents, dermatologic agents, and agents that damage the liver.
Interactions with Herbs and Dietary Supplements
Alpha-ketoglutarate may interact with amino acids, cardiovascular herbs and supplements, dermatologic herbs and supplements, herbs and supplements that damage the liver, and herbs and supplements that reduce blood phosphate or phosphorus levels.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Blomqvist, B. I., Hammarqvist, F., von der, Decken A., and Wernerman, J. Glutamine and alpha-ketoglutarate prevent the decrease in muscle free glutamine concentration and influence protein synthesis after total hip replacement. Metabolism 1995;44(9):1215-1222. View Abstract
Bonnefont, J. P., Chretien, D., Rustin, P., Robinson, B., Vassault, A., Aupetit, J., Charpentier, C., Rabier, D., Saudubray, J. M., and Munnich, A. Alpha-ketoglutarate dehydrogenase deficiency presenting as congenital lactic acidosis. J.Pediatr. 1992;121(2):255-258. View Abstract
Gibson, G. E., Zhang, H., Sheu, K. F., Bogdanovich, N., Lindsay, J. G., Lannfelt, L., Vestling, M., and Cowburn, R. F. Alpha-ketoglutarate dehydrogenase in Alzheimer brains bearing the APP670/671 mutation. Ann.Neurol. 1998;44(4):676-681. View Abstract
Hammarqvist, F., Wernerman, J., von der, Decken A., and Vinnars, E. Alpha-ketoglutarate preserves protein synthesis and free glutamine in skeletal muscle after surgery. Surgery 1991;109(1):28-36. View Abstract
Jeppsson, A., Ekroth, R., Friberg, P., Kirno, K., Milocco, I., Nilsson, F. N., Svensson, S., and Wernerman, J. Renal effects of alpha-ketoglutarate early after coronary operations. Ann.Thorac.Surg. 1998;65(3):684-690. View Abstract
Kjellman, U. W., Bjork, K., Ekroth, R., Karlsson, H., Jagenburg, R., Nilsson, F. N., Svensson, G., and Wernerman, J. Addition of alpha-ketoglutarate to blood cardioplegia improves cardioprotection. Ann.Thorac.Surg. 1997;63(6):1625-1633. View Abstract
Kjellman, U., Bjork, K., Ekroth, R., Karlsson, H., Jagenburg, R., Nilsson, F., Svensson, G., and Wernerman, J. Alpha-ketoglutarate for myocardial protection in heart surgery. Lancet 3-4-1995;345(8949):552-553. View Abstract
Mason, G. F., Gruetter, R., Rothman, D. L., Behar, K. L., Shulman, R. G., and Novotny, E. J. Simultaneous determination of the rates of the TCA cycle, glucose utilization, alpha-ketoglutarate/glutamate exchange, and glutamine synthesis in human brain by NMR. J.Cereb.Blood Flow Metab 1995;15(1):12-25. View Abstract
Mastrogiacomo, F. and Kish, S. J. Cerebellar alpha-ketoglutarate dehydrogenase activity is reduced in spinocerebellar ataxia type 1. Ann.Neurol. 1994;35(5):624-626. View Abstract
Meissner, T., Mayatepek, E., Kinner, M., and Santer, R. Urinary alpha-ketoglutarate is elevated in patients with hyperinsulinism-hyperammonemia syndrome. Clin.Chim.Acta 2004;341(1-2):23-26. View Abstract
Riedel, E., Hampl, H., Steudle, V., and Nundel, M. Calcium alpha-ketoglutarate administration to malnourished hemodialysis patients improves plasma arginine concentrations. Miner.Electrolyte Metab 1996;22(1-3):119-122. View Abstract
Riedel, E., Nundel, M., and Hampl, H. alpha-Ketoglutarate application in hemodialysis patients improves amino acid metabolism. Nephron 1996;74(2):261-265. View Abstract
Wernerman, J., Hammarqvist, F., and Vinnars, E. Alpha-ketoglutarate and postoperative muscle catabolism. Lancet 3-24-1990;335(8691):701-703. View Abstract
Wiren, M., Permert, J., and Larsson, J. Alpha-ketoglutarate-supplemented enteral nutrition: effects on postoperative nitrogen balance and muscle catabolism. Nutrition 2002;18(9):725-728. View Abstract
Zimmermann, E., Wassmer, S., and Steudle, V. Long-term treatment with calcium-alpha-ketoglutarate corrects secondary hyperparathyroidism. Miner.Electrolyte Metab 1996;22(1-3):196-199. View Abstract
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017